One of the issues most dear to my heart is allowing people with disabilities to receive the care they need at home, instead of being forced into an institution. I first learned about this issue several years back when I read "No Pity" by Joseph Shapiro.

Essentially, the problem is this: Medicaid, which is the health insurance most people with disabilities have, must provide nursing home services by law, but community-based approaches, such as home care and small group home care is optional and decided state by state. This means that far more people are in nursing homes than need or want to be. It also means that taxpayers are spending way more on healthcare for these people than is necessary. Nursing homes are more than 10 times more expensive than home care. All the research shows, and people with disabilities will tell you, we are happier and healthier at home.

Proposal 4, in a nutshell, would ensure that people who need help with everyday tasks, like taking medicine, getting dressed and bathing would have the choice to have someone come into their home to provide these services, rather than being forced into a nursing home. It also would ensure that people looking for help with these tasks, and trained professionals looking to help with these tasks, could all be on one registry with information about specific needs and preferences. This is an empowering approach for seniors, people with disabilities and home healthcare workers.